Pandemic Response: PPE Conservation, Crew Protection, and Workforce Practice Questions

25 multiple-choice questions on Pandemic response: PPE conservation, crew protection, and workforce for paramedic and EMT students, from Chapter 52 (Disaster Response). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. When N95 respirators are scarce, CDC prefers extended use over reuse mainly because extended use:

   1. A. Allows more donnings before it is discarded
   2. B. Keeps the filter's efficiency from dropping
   3. C. Means fewer touches of a contaminated mask
   4. D. Removes the need for a fit test first
   Show answer

   Answer: C. Means fewer touches of a contaminated mask

   In extended use, the same N95 stays on through several patient encounters without being removed, so the provider handles the contaminated outer surface less often. Reuse means taking it off and putting it back on, which raises the risk of self-contamination. Extended use does not add donnings, which belong to reuse, and filter efficiency stays high with wear under either strategy; soiling, damage, and harder breathing are what end a mask's use. Fit testing is still required.

2. During a pandemic surge, your agency tells crews to wear one N95 through several patient contacts in a row. You should:

   1. A. Keep it on and avoid touching the front
   2. B. Take it off between calls and store it in a pocket
   3. C. Spray it with disinfectant between patients
   4. D. Trade masks with your partner between calls
   Show answer

   Answer: A. Keep it on and avoid touching the front

   Extended use works only if the respirator stays on and the wearer avoids touching its contaminated front; hands are cleaned if it is touched. Disinfectant sprays damage the filter and can be inhaled.

3. An N95 respirator in extended use should be discarded when it:

   1. A. Has been worn for more than a single call
   2. B. Becomes warm and moist from the wearer's breath
   3. C. Is no longer clearly marked with its brand
   4. D. Is soiled, damaged, or hard to breathe through
   Show answer

   Answer: D. Is soiled, damaged, or hard to breathe through

   Under extended use, an N95 is discarded once it is damaged, visibly soiled (as with blood or secretions), wet, or hard to breathe through, or after an aerosol-generating procedure. Discarding after every call is conventional practice that shortages do not allow.

4. During a respirator shortage, an elastomeric half-mask respirator helps conserve supplies because it:

   1. A. Needs no fit test before use
   2. B. Is cheaper per unit than an N95
   3. C. Can be shared without cleaning
   4. D. Can be cleaned and used again
   Show answer

   Answer: D. Can be cleaned and used again

   Elastomeric respirators have a reusable face piece with replaceable filters and can be cleaned and disinfected between uses. They still need fit testing, like any tight-fitting respirator. Each elastomeric costs more than an N95 at first, and it must be cleaned and disinfected before another person wears it; the savings come from using it again for many shifts.

5. Your ambulance has no partition between the cab and the patient compartment. During a transport for a suspected airborne pandemic illness, the driver should:

   1. A. Remove PPE to drive more safely
   2. B. Set the cab fan to recirculate air
   3. C. Wear an N95 respirator while driving
   4. D. Keep the cab windows fully closed
   Show answer

   Answer: C. Wear an N95 respirator while driving

   Without an isolated driver compartment, the driver shares air with the patient and needs a respirator, with ventilation set to bring in outside air rather than recirculate. Recirculating air keeps aerosols circulating through the cab.

6. Dispatch reports that a 911 caller with fever and cough screened positive for a pandemic illness. On arrival, the best approach is to:

   1. A. Don PPE, then have one provider assess first
   2. B. Have both providers enter quickly without PPE
   3. C. Have both providers enter in full PPE
   4. D. Enter with gloves and surgical masks
   Show answer

   Answer: A. Don PPE, then have one provider assess first

   Positive dispatch screening lets crews put on PPE before contact, and limiting initial contact to one provider reduces exposures until the need for more hands is clear. Entering without PPE to save time risks infecting the crew and later patients. Sending both providers in, even in full PPE, doubles the exposure before more hands are known to be needed, and gloves with surgical masks lack the respiratory protection recommended for a suspected pandemic respiratory illness.

7. A patient with suspected pandemic influenza needs oxygen at 2 L/min by nasal cannula. For source control, you should:

   1. A. Withhold oxygen to avoid making aerosols
   2. B. Place a surgical mask over the cannula
   3. C. Switch to a nebulizer mask at 8 L/min
   4. D. Put a valved N95 respirator on the patient
   Show answer

   Answer: B. Place a surgical mask over the cannula

   A surgical mask over the nasal cannula reduces the spread of droplets while still allowing oxygen therapy. Withholding needed oxygen is harmful, and a valved N95 lets exhaled air out unfiltered, so it does not provide source control.

8. A wheezing patient with a suspected pandemic respiratory illness needs albuterol. To limit aerosol generation, you should give it by:

   1. A. Nebulizer in the closed ambulance
   2. B. Metered-dose inhaler with a spacer
   3. C. Nebulizer with the doors left open
   4. D. Continuous nebulizer by face mask
   Show answer

   Answer: B. Metered-dose inhaler with a spacer

   Nebulizers create aerosols that can carry virus throughout the patient compartment, so pandemic protocols favor an MDI with a spacer when the patient can use it. Opening the doors does not make nebulizer use safe for the crew.

9. You are dispatched to a cardiac arrest in a patient with a suspected pandemic respiratory infection, and your unit carries full PPE with N95 respirators. Under the 2025 AHA guidelines, the crew should:

   1. A. Skip PPE so compressions start sooner
   2. B. Do compressions in gloves and a surgical mask
   3. C. Ventilate mouth-to-mask until PPE is on
   4. D. Use PPE, including a respirator, during CPR
   Show answer

   Answer: D. Use PPE, including a respirator, during CPR

   The 2025 AHA guidelines treat chest compressions, bag-mask ventilation, defibrillation, suctioning, and intubation as aerosol-generating procedures and state that it is reasonable for rescuers to use PPE during CPR when it is immediately available; with full PPE on the unit, the crew puts it on, including a respirator, as they go in. Skipping PPE so compressions start sooner exposes the crew, and an infected crew cannot help this patient or the next one. Gloves and a surgical mask do not protect against aerosols. Mouth-to-mask ventilation puts the rescuer's face closest to the patient's exhaled air. (2025 AHA Part 7 and Part 10.)

10. When ventilating a patient with a suspected airborne infection by bag-mask device, you should add:

    1. A. A heat-moisture exchanger with no filter
    2. B. A PEEP valve set at 20 cm H2O
    3. C. A HEPA filter between mask and bag
    4. D. A surgical mask over the bag's exhaust port
    Show answer

    Answer: C. A HEPA filter between mask and bag

    A HEPA (high-efficiency particulate air) filter on the exhalation path traps infectious particles, and a tight two-hand mask seal reduces leaks. A high PEEP setting does not filter aerosols and can drop the blood pressure. A plain heat-moisture exchanger humidifies but does not filter infectious particles, and a surgical mask draped over the exhaust port is not a tested filter and can obstruct the valve.

11. During an aerosol-generating procedure on a pandemic patient, the number of providers in the patient compartment should be:

    1. A. The fewest needed to do it safely
    2. B. The whole crew, so roles can rotate
    3. C. Two at most, whatever the procedure
    4. D. At least four, to share the workload
    Show answer

    Answer: A. The fewest needed to do it safely

    Limiting the people present during intubation, suction, or CPR reduces the number exposed to aerosols, while keeping enough hands to do the procedure safely. A fixed cap that ignores the procedure's needs can compromise care. Bringing the whole crew in so roles can rotate exposes everyone, when helpers can wait outside until they are needed.

12. After transporting a patient with a suspected airborne pandemic illness, the crew should first:

    1. A. Close the doors to keep the virus trapped inside
    2. B. Leave the doors open to air out, then clean
    3. C. Spray disinfectant and leave right away
    4. D. Wipe the cab and leave the patient area
    Show answer

    Answer: B. Leave the doors open to air out, then clean

    Airing out the patient compartment with doors open lets suspended particles clear before the crew starts cleaning with an approved disinfectant. Spraying and leaving skips the contact time the disinfectant needs to work.

13. Pandemic planners commonly assume that at the peak of a severe pandemic wave, staff absenteeism may reach about:

    1. A. 40%
    2. B. 5%
    3. C. 10%
    4. D. 80%
    Show answer

    Answer: A. 40%

    Federal pandemic planning assumes absenteeism of up to about 40% at the peak of a severe wave, from illness, caring for family members, and fear. Planning for 5% to 10% leaves agencies unable to staff units when demand is highest.

14. During a pandemic wave, 30% of your crews call off. Besides their own illness, a major cause that agency planners should address is:

    1. A. A lack of overtime pay rules
    2. B. Fuel shortages at the pumps
    3. C. Strikes over hazard pay
    4. D. Childcare when schools close
    Show answer

    Answer: D. Childcare when schools close

    School and daycare closures keep many providers at home, so pandemic plans include childcare support and family care options. Overtime rules matter, but they do not keep a parent from leaving young children alone. Fuel shortages go with power outages and storms rather than pandemics, and strikes have not been a major cause of pandemic absenteeism; illness, caring for sick family members, school closures, and fear of exposure are.

15. Pandemic vaccination plans place EMS providers in early priority groups mainly because they:

    1. A. Have weaker immune systems than most
    2. B. Are legally required to be vaccinated
    3. C. Face high exposure and keep care going
    4. D. Can later give the vaccine to the public
    Show answer

    Answer: C. Face high exposure and keep care going

    EMS providers are at high risk of exposure and are essential to keep the health system running, so protecting them protects both the workforce and patients. Their immune systems are not weaker than average.

16. A paramedic had an unprotected exposure to a patient with confirmed pandemic influenza. Many plans call for:

    1. A. A tetanus booster and immune globulin
    2. B. Antibiotics such as oral amoxicillin
    3. C. Quarantine of her whole household for 2 weeks
    4. D. Antiviral prophylaxis such as oseltamivir
    Show answer

    Answer: D. Antiviral prophylaxis such as oseltamivir

    Antiviral drugs such as oseltamivir can reduce the chance of illness after a significant influenza exposure, keeping the provider at work. Antibiotics do not act on viruses.

17. To keep sick staff from spreading a pandemic illness at work, agencies should:

    1. A. Screen staff for symptoms before each shift
    2. B. Require sick staff to keep working in N95 masks
    3. C. Test staff once an outbreak has occurred
    4. D. Check staff temperatures once a month
    Show answer

    Answer: A. Screen staff for symptoms before each shift

    Daily symptom screening, with clear rules to stay home when ill, keeps infected providers from exposing coworkers and patients. Working sick in a mask still spreads infection and adds fatigue errors.

18. Under pandemic crisis protocols, a paramedic leaves a low-acuity patient at home with telehealth follow-up instead of transporting him. The key safeguard for this practice is:

    1. A. The patient's signed refusal form alone
    2. B. Clear criteria with medical oversight
    3. C. A follow-up call from the same crew
    4. D. The paramedic's own judgment and feel
    Show answer

    Answer: B. Clear criteria with medical oversight

    Nontransport under altered pandemic protocols must follow written criteria and medical direction, with quality review, so safety is not left to individual judgment. A refusal form alone does not protect a patient who was never offered transport.

19. Influenza pandemics have usually occurred as:

    1. A. One peak lasting about a week
    2. B. Short, local clusters of cases
    3. C. Waves over months to years
    4. D. A single wave each summer
    Show answer

    Answer: C. Waves over months to years

    Pandemics often come in several waves, and later waves may be worse, so plans must sustain staff, supplies, and morale for a long time. Planning for one short peak exhausts resources early.

20. Which is a nonpharmaceutical intervention used to slow a pandemic?

    1. A. Mass antibiotic prophylaxis of the public
    2. B. Antivirals given to healthy residents
    3. C. Distancing and limits on large gatherings
    4. D. Vaccinating residents within one day
    Show answer

    Answer: C. Distancing and limits on large gatherings

    Nonpharmaceutical interventions, such as distancing, masking, handwashing, and closing gatherings, slow spread when vaccines and drugs are not yet available. Antibiotics have no effect on viral pandemics.

21. During a pandemic surge, ambulances wait hours to transfer patients at the busiest emergency departments. The best system response is:

    1. A. Leaving patients alone in ED hallways
    2. B. Taking the patients to one hospital
    3. C. Stopping transports until the wait ends
    4. D. Regional load balancing among hospitals
    Show answer

    Answer: D. Regional load balancing among hospitals

    Coordinating destinations across a region spreads patients among hospitals with capacity and returns ambulances to service. Leaving patients unattended in hallways abandons them without a formal handoff.

22. When removing PPE after a high-risk pandemic call, the safest practice is to:

    1. A. Follow a set order with a trained observer
    2. B. Remove it in one motion, as fast as possible
    3. C. Take off the respirator before the gloves
    4. D. Remove it inside the clean driver's cab
    Show answer

    Answer: A. Follow a set order with a trained observer

    A trained observer watching a set doffing sequence catches errors that lead to self-contamination, which is when many exposures happen. Removing the respirator before the gloves touches the face with contaminated hands.

23. To limit equipment contamination on pandemic calls, crews should bring into the residence:

    1. A. The unit's full set of bags, just in case
    2. B. A small kit chosen for the call type
    3. C. The monitor and stretcher as a routine
    4. D. The full airway kit, whatever the call
    Show answer

    Answer: B. A small kit chosen for the call type

    Carrying only the equipment likely to be needed reduces what must be cleaned or thrown away; more can be brought in once the patient is assessed. Bringing every bag into the home exposes all of it to contamination.

24. During a pandemic surge, the 911 center is flooded with calls from people who have mild cold symptoms. Which step best keeps ambulances available for true emergencies?

    1. A. Send the closest ALS ambulance to each caller
    2. B. Route screened low-acuity callers to a nurse line
    3. C. Hold callers in a queue until a unit is free
    4. D. Tell callers to drive themselves to the nearest ED
    Show answer

    Answer: B. Route screened low-acuity callers to a nurse line

    Structured call screening, with low-acuity callers referred to a nurse navigation or telehealth line under medical direction, keeps ambulances free for life threats while still giving callers medical advice; pandemic EMS plans list dispatch triage and alternate dispositions as core surge strategies. Sending the closest ALS ambulance to each caller uses up units on mild illness and leaves none for cardiac arrests and major trauma. Holding callers in a queue delays help for everyone, including the few who are critically ill. Sending people with mild symptoms to the ED crowds the hospitals, spreads infection in waiting rooms, and lengthens ambulance offload times.

25. A patient with a suspected pandemic respiratory illness is in cardiac arrest and needs an advanced airway. Under the 2025 AHA guidelines, the preferred approach is:

    1. A. Repeated attempts by each crew member in turn
    2. B. Prolonged bag-mask ventilation before an airway
    3. C. Video laryngoscopy with a HEPA filter
    4. D. A supraglottic airway with no filter attached
    Show answer

    Answer: C. Video laryngoscopy with a HEPA filter

    For patients with suspected high-consequence respiratory pathogens, the 2025 AHA guidelines prefer video laryngoscopy over direct laryngoscopy, which keeps the provider's face farther from the airway and improves first-pass success, and they call for a HEPA filter on ventilation devices whenever possible. Repeated attempts by each crew member in turn raise both exposure and delays. Prolonged bag-mask ventilation is itself aerosol-generating and is a poor substitute for an early, filtered airway. A supraglottic airway with no filter attached releases unfiltered exhaled air; any device in the circuit needs a HEPA filter. (2025 AHA Part 10.)